An economic evaluation of the Whole Genome Sequencing source tracking program in the U.S.

The U.S. Food and Drug Administration (FDA) created the GenomeTrakr Whole Genome Sequencing (WGS) Network in 2013, as a tool to improve food safety. This study presents an analysis of Whole Genome source tracking implementation on potential food contamination and related illnesses through theoretical, empirical, and cost benefit analyses. We conduct empirical tests using data from FDA regulated food commodity outbreaks garnering FDA response from 1999 through 2019 and examine the effect of the National Center for Biotechnology Information (NCBI) Pathogen detection program of source tracking WGS isolates collected in the U.S. on outbreak illnesses for three pilot pathogens (E. coli, Listeria, and Salmonella). Empirical results are consistent with the theoretical model and suggest that each additional 1,000 WGS isolates added to the public NCBI database is associated with a reduction of approximately 6 illnesses per WGS pathogen, per year. Empirical results are connected to existing literature for a Monte Carlo analysis to estimate benefits and costs. By 2019, annual health benefits are estimated at nearly $500 million, compared to an approximately $22 million investment by public health agencies. Even under conservative assumptions, the program likely broke even in its second year of implementation and could produce increasing public health benefits as the GenomeTrakr network matures.

Body Weight and Suicidal Behavior in Adolescent Females: The Role of Self-Perceptions.

BACKGROUND: Suicide is the third leading cause of death among adolescents and recent data indicate that the suicide rate, particularly for young girls, is increasing. Excess body weight among adolescents has also been documented widely over the last two decades and is considered one of the most pressing public health concerns today. Previous literature has examined the relationship between actual body weight and suicidal behavior, but there is little evidence on self-perception of weight and suicidal behaviors. AIM OF THE STUDY: This study examines the relationship between body weight and suicidal behaviors using a rich longitudinal data set of a large nationally-representative sample of female adolescents to account for a number of confounding factors. The study explores the relationship, not only between actual weight status and suicidal behaviors, but also between self-perception of weight and suicidal behaviors. METHOD: Using data from a nationally-representative sample of adolescents in the United States, the study ascertains the effect of body weight status on suicidal behaviors by estimating endogeneity-corrected models including school-level fixed effects to account for bi-directionality and unobserved confounders. Actual body weight status was calculated using interviewer-measured height and weight. The study also used a measure of self-perceived weight status to compare how actual versus self-perceived weight status affects suicidal behavior. Thinking about committing suicide and attempting to commit suicide in the past 12 months were utilized as dichotomous measures of suicidal behaviors. Potential mediators between suicidal behaviors and weight status such as family history of suicide, participation in risky health behaviors and parental characteristics were also controlled for in the analysis. The analytical sample consists of 5,430 adolescent females aged 11 to 18. RESULTS: The results suggest that both self-perceived and measured weight status (overweight or obese) increase a female adolescent's probability of suicidal ideation, with self-perceived weight status causing a larger increase in suicidal ideation. There is some evidence that body weight status affects suicide attempts, but these results are much less robust. Finally, endogeneity bias is shown to be of concern in all estimates, and failing to account for this bias is likely to understate any estimated effect. IMPLICATIONS FOR HEALTH POLICY: The results have important implications for the design of public health programs to prevent adolescent suicide, especially among female adolescents. Understanding the mechanisms through which adolescents are motivated to take such dire actions will help to allocate resources into the treatment areas which are most effective in stemming the rise of suicidal behaviors. This study identifies one key factor, self-perception of weight, which may be an avenue for mental health care providers to continue exploring. IMPLICATIONS FOR FUTURE RESEARCH: Further research on this topic could include not only studying the impact of body weight on suicidal behaviors, but also examining the relationships between body weight and other important mental health outcomes such as psychological distress and major depressive episodes.

A comparison of diagnosed and undiagnosed diabetes patients and labor supply.

Using data from four waves of the National Health and Nutrition Examination Survey, we examine the difference between individuals with diagnosed and undiagnosed cases of type 2 diabetes and their labor supply decisions. We show that a diagnosis of type 2 diabetes is significantly associated with a reduction in both male and female employment probability by 11 and 19 percentage points, respectively. Additionally, hours worked by individuals with diagnosed type 2 diabetes are 7h lower per week for males and 8h lower per week for females. Further, individuals with undiagnosed type 2 diabetes experience a drop in labor supply somewhat smaller but similar to their diagnosed counterparts. This association may be driven by the similarities between undiagnosed and very recently diagnosed type 2 diabetes. In all estimations, we consistently find that type 1 diabetes has a different effect than either diagnosed or undiagnosed type 2 diabetes.

The Per Case and Total Annual Costs of Foodborne Illness in the United States.

We present an economic welfare-based method to estimate the health costs associated with foodborne illness caused by known viruses, bacteria, parasites, allergens, two marine biotoxins, and unspecified agents. The method generates health costs measured in both quality-adjusted life years and in dollars. We calculate the reduction in quality-adjusted life days caused by the illness and add reductions in quality-adjusted life years from any secondary effects that are estimated to occur. For fatal cases, we calculate the life years lost due to premature death. We add direct medical expenses to the monetary costs as derived from estimates of willingness to pay to reduce health risks. In total, we estimate that foodborne illness represents an annual burden to society of approximately $36 billion, with an average identified illness estimated to reduce quality-adjusted life days by 0.84, which is monetized and included in the average cost burden per illness of $3,630.

Estimating the biases associated with self-perceived, self-reported, and measured BMI on mental health.

PURPOSE: The purpose of the study is to explore the relationship between individuals' perceptions of their weight-status, self-reported height and weight, and measured weight status. METHODS: A national survey of 9,248 adolescents (47% male) between the ages of 11 and 27 is analyzed to determine whether inaccuracies in reporting are caused by misperception or conscious intent, and whether there tends to be a systematic bias in how individuals self-report. Self-esteem was used as an example of an important outcome variable in order to illustrate the magnitudes of the biases that may arise when using different measures of body size. RESULTS: Our results indicate that measured obesity status is associated with the reduction in Rosenberg Self-Esteem (RSE) of 0.30 points (p-value 0.005) among adolescents and 0.20 points (p-value 0.002) among young adults; in addition, using self-reported height and weight as opposed to measured height and weight does not result in a statistically detectable difference in the estimates. CONCLUSIONS: Individuals' self-reports of height and weight are not as unreliable as we might have expected. Although estimates from measured height and weight are preferred, in the absence of such measures, self-reported measures would likely be a reliable alternative. The differences in self-perception of weight status, however, imply that it is not comparable to measured weight categories.

An investigation into the effect of type I and type II diabetes duration on employment and wages.

Using data from the National Longitudinal Survey of Youth 1979, the current study examines the effect of type I and type II diabetes on employment status and wages. The results suggest that both the probability of employment and wages are negatively related to the number of years since the initial diagnosis of diabetes. Moreover, the effect of diabetes duration on the probability of employment appears to be nonlinear, peaking around 16 years for females and 10 years for males. A similar negative effect on wages is found only in male diabetics. Finally, the results suggest that failure to distinguish between type I and type II diabetics may lead to some counterintuitive results.

The effect of diabetes on female labor force decisions: new evidence from the National Health Interview Survey.

This paper estimates the effect of diabetes on labor-force participation, hours worked, days-out-of-work due to illness, and earnings using data from the National Health Interview Survey. Findings indicate that diabetes, estimated wholly, is significantly detrimental to most labor market outcomes. However, separation of type I and II diabetes shows that much of the negative effect is due to type II diabetes. On average a female with type II diabetes can experience a wage penalty of almost 50% relative to a healthy individual. Additionally, estimates of specifically type II diabetes may be subject to endogeneity bias. To account for this, I utilize whether an individual's biological mother has been diagnosed with diabetes as an instrumental variable. This instrument provides both theoretical and statistical explanatory power to separate the causal effect of type II diabetes on labor-force decisions.